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C.D.C. Director Defends Boosters for Frontline Workers
Despite an agency advisory panel’s refusal to endorse booster shots of the Pfizer-BioNTech coronavirus vaccine for frontline workers, Dr. Rochelle Walensky said she recommended the shots to protect communities disproportionately impacted by the pandemic.
In an effort to protect those at greatest risk, our initial vaccine rollout prioritized these individuals, the everyday heroes of our society. Our health care systems are, once again, at maximum capacity in parts of the country. Our teachers are facing uncertainty as they walk into the classroom, and I must do what I can to preserve the health across our nation. I’m also aware of the disproportionate impact this pandemic has had on racial and ethnic minority communities. Many of our frontline workers, essential workers and those in congregate settings come from communities that have already been hardest hit. Withholding access for boosters from these people and communities would only worsen the inequities that I have committed to fight against. It was a decision about providing rather than withholding access. I, too, thought of the stressors of the current moment of this pandemic and the principles of access and equity in my decision. I want to be very clear that I did not overrule an advisory committee. This wasn’t — I listened to all of the proceedings of the F.D.A. advisory committee, and intently listened to this exceptional group of scientists that publicly and very transparently deliberated for hours over some of these very difficult questions, and where the science was. This was a scientific close call. In that situation, it was my call to make.
Despite an agency advisory panel’s refusal to endorse booster shots of the Pfizer-BioNTech coronavirus vaccine for frontline workers, Dr. Rochelle Walensky said she recommended the shots to protect communities disproportionately impacted by the pandemic.CreditCredit…Rachel Woolf for The New York Times
As President Biden cheered moves by federal regulators to allow for millions of Americans to get booster shots of the Pfizer-BioNTech coronavirus vaccine on Friday, the director of the Centers for Disease Control and Prevention defended her decision to recommend the shots for frontline workers, a highly unusual move because it overruled her agency’s scientific advisers.
“I want to be very clear that I did not overrule an advisory committee,” the director, Dr. Rochelle Walensky, told reporters at a White House briefing, saying she had listened to the panel’s discussion. “This was a scientific close call. In that situation, it was my call to make.”
She added, “it was a decision about providing rather than withholding access.”
Dr. Walensky’s pointed remarks underscored growing confusion around the start of the long-awaited booster rollout.
Earlier on Friday, Mr. Biden appeared at the White House to hail the decision by federal regulators to clear Pfizer boosters for many Americans who had a second dose of the Pfizer vaccine at least six months ago. He urged those eligible for a third shot to get one quickly to fortify their protection to the dangerous Delta variant that swept through the country this summer.
“My message today is this: If you’ve got the Pfizer vaccine, you got the Pfizer vaccine in January, February, March of this year, and you’re over 65 years of age, go get the booster,” Mr. Biden said. “Or, if you’re in a have a medical condition like diabetes, or you’re a frontline worker like a health care worker or a teacher, you can get a free booster.”
Mr. Biden, who is 78 and began his Pfizer vaccination in December, is eligible for a booster and said he would get one “as soon as I can get it done.”
On Wednesday, after weeks of internal strife, the Food and Drug Administration granted emergency authorization to Pfizer to begin making the shots available to people who fell into three categories: those over 65 who had received their second dose of the vaccine at least six months ago; adults whose underlying conditions put them at high risk of becoming severely ill with Covid-19; frontline workers like teachers and health care workers whose jobs put them at risk.
But the C.D.C.’s Advisory Committee on Immunization Practices met on Thursday and departed from that recommendation. Like the F.D.A., it called for Pfizer boosters for a wide range of Americans, including tens of millions of older adults, and younger people at high risk for the disease. But the panel excluded health care workers, teachers and others whose jobs put them at risk.
Early Friday morning, Dr. Walensky stepped in and reconciled the differences by calling for frontline workers to get the shots, aligning C.D.C. policy with the F.D.A.’s endorsements over her own agency’s advisers.
In his appearance at the White House, Mr. Biden did not address the criticism that his administration gotten ahead of the regulatory process after he announced a plan for Pfizer and Moderna boosters in mid-August, nor the internal disagreement in his administration about the need for boosters.
Over the weeks, many independent scientists and regulators had emphasized that there was little research on who might benefit from the extra shots. Eventually the plan to quickly provide Moderna boosters was dropped, to give the F.D.A. more time to collect and study data. And scientific advisers to the F.D.A. and C.D.C. wrestled over the last week with who should get Pfizer boosters and why.
Scientific advisers to the F.D.A. and C.D.C. have been not asked to judge whether people who received the Moderna and Johnson & Johnson vaccines should receive any additional doses. Booster shots for Moderna and Johnson & Johnson vaccine recipients have not been authorized by the F.D.A.
The advisers to the C.D.C. also wrestled with the practicalities of endorsing a booster shot for only Pfizer-BioNTech recipients, when close to half of vaccinated Americans have received Moderna or Johnson & Johnson vaccines.
Some global health experts have criticized the Biden administration for pushing booster shots when much of the world has yet to receive a first dose. But analysts noted that even if the United States distributes booster shots, there should still be considerable excess vaccine supply this year, and they urged the government to begin sending the extra doses abroad.
In his remarks, Mr. Biden complained again about the resistance to the vaccine.
“Despite the fact that for almost five months free vaccines have been available in 80,000 locations, we still have over 70 million Americans who fail to get a single shot,” he said. “And to make matters worse, there are elected officials actively working to undermine with false information the fight against Covid-19.”
“This is totally unacceptable,” he said.
Dan Levin, Daniel E. Slotnik and Zachary Montague contributed reporting.
Credit…Kevin Mohatt for The New York Times
On the heels of federal officials’ endorsement of booster shots of the Pfizer-BioNTech coronavirus vaccine for many fully inoculated Americans, some states announced plans for getting even more shots in arms.
Dr. Rochelle P. Walensky, the director of the Centers for Disease Control and Prevention, recommended on Friday morning vaccines for frontline workers, as well as for people older than 65 and many people with underlying health conditions, overruling an agency advisory panel. Individuals must also have received a second dose of the Pfizer vaccine at least six months ago.
Tens of millions of Americans woke up eligible for booster shots. In one recent poll, about three-quarters of vaccinated Americans said they would opt for a booster if the doses were available, and some sought them out long before they were authorized. Federal officials recommended self-attestation on Friday as the best method to determine who could get a booster dose.
“We’ve worked closely with partners including governors, pharmacies, doctors, long-term care facilities, and other providers, so that eligible Americans are able to get a booster shot at roughly 80,000 places across the country, including over 40,000 local pharmacies,” Jeffrey D. Zients, the White House coronavirus response coordinator, said at a news conference on Friday.
More than 70 percent of current vaccine administration was already taking place in pharmacies, according to a C.D.C. presentation at the meeting of agency advisers on Thursday.
CVS, Rite Aid and Walgreens all said that they would begin administering boosters on Friday.
CVS said it will rely on “self-attestation” from customers to determine eligibility.
State health departments generally follow the recommendations of the C.D.C., and many on Friday were eager to move ahead.
In Maryland, Gov. Larry Hogan announced that all eligible state residents could immediately get booster shots following federal clearance, which he called “long overdue.”
In Indiana, the health department announced that Pfizer boosters were now available to eligible residents.
And in Vermont, officials said that residents ages 80 and older could register for boosters, and the state would expand eligibility to those 65 and older over the next week.
Many states began organizing their booster rollouts shortly after President Biden announced a plan for Pfizer and Moderna boosters in mid-August, but the plan was followed by criticism that the White House was getting ahead of the regulatory process, and internal disagreement in the Biden administration about the need for boosters.
Over the weeks, many independent scientists and regulators had emphasized that there was little research on who might benefit from the extra shots. Eventually the plan to quickly provide Moderna boosters was dropped, to give the F.D.A. more time to collect and study data. And scientific advisers to the F.D.A. and C.D.C. wrestled over the last week with who should get Pfizer boosters and why.
In California, Gov. Gavin Newsom announced a plan that will help eligible people access boosters, mainly through pharmacies and their primary care providers. Mass vaccination sites in the state could be reopened, according to the plan.
Across the country, New York planned to help distribute the shots by making $65 million available to local health departments, who would lead the way on booster distribution, and offering training to more than 50,000 emergency medical technicians to administer the vaccine, Gov. Kathy Hochul said in recent weeks.
“We think it’s really important that more people get this just as an extra layer of protection, like putting on an extra winter coat as the weather starts getting colder,” Ms. Hochul said at a news conference on Thursday, adding that boosters will be made available at pharmacies, nursing homes and on-site at different businesses.
In New York City, Mayor Bill de Blasio said earlier this month that the city would utilize more than 1,900 vaccination sites across the five boroughs and make various outreach efforts. He said eligible New Yorkers could get boosters “as of this exact moment” in an interview Friday morning on “The Brian Lehrer Show” on WNYC.
Alison Beam, Pennsylvania’s acting health secretary, signed an order on Tuesday that will require vaccine providers to offer online scheduling for vaccine appointments, live scheduling assistance, walk-in appointments and coordination with local care agencies to help schedule homebound residents.
In West Virginia, which faces some of the worst virus conditions of any state, Gov. Jim Justice and public health officials have been calling for federal regulators to sign off on boosters to shore up protection for older, more vulnerable citizens.
“Our federal government moves like a turtle, and a lot of times it moves like a turtle in the wrong direction,” he said at a news conference on Friday.
Maj. Gen. Jim Hoyer, a retired National Guard officer who leads the interagency task force that coordinates West Virginia’s vaccination efforts, said on Friday that boosters were already “being given as we are on this press conference.”
Coral Murphy Marcos contributed reporting.
Credit…Sarahbeth Maney/The New York Times
President Biden on Friday urged people who are not yet eligible for coronavirus booster shots to be patient, while suggesting eligibility could expand rapidly.
He said that his administration was “looking to the time when we’re going to be able to expand the booster shots, basically across the board,” and that boosters for the Moderna and Johnson & Johnson vaccines were likely in the offing.
“So I would just say, it’d be better to wait your turn in line, wait your turn to get there,” Mr. Biden said.
His remarks came hours after Dr. Rochelle P. Walensky, the director of the Centers for Disease Control and Prevention, recommended booster doses of the Pfizer-BioNTech coronavirus vaccine for frontline workers, as well as for people older than 65 and many people with underlying health conditions, overruling an agency advisory panel. Individuals must also have received a second dose of the Pfizer vaccine at least six months ago. Her move, though highly unusual, aligned C.D.C. policy with the Food and Drug Administration’s endorsements over her own agency’s advisers.
According to the C.D.C., as of Friday, more than 100 million of the fully vaccinated people in the United States received the Pfizer vaccine, while more than 82 million — or about 45 percent of the total — received Moderna and Johnson & Johnson doses.
Scientific advisers to the F.D.A. and C.D.C. have been not asked to judge whether people who received the Moderna and Johnson & Johnson vaccines should receive any additional doses. Booster shots for Moderna and Johnson & Johnson vaccine recipients have not been authorized by the F.D.A. Still, many Americans have already scrambled to get boosters even before federal regulators signed off this week on Pfizer boosters, typically by finding a cooperative pharmacist or by claiming to be unvaccinated.
The C.D.C. advisers noted this week that recipients of Moderna and Johnson & Johnson vaccines might understandably feel resentful of being asked to wait if the evidence suggests they need boosters.
Dr. Sarah Long, a pediatrician and infectious diseases expert at Drexel University College of Medicine in Pennsylvania, said she didn’t understand how the authorities could “say to people 65 and older, ‘You’re at risk for severe disease and death, but only half of you can protect yourselves right now.’”
“It might be the right thing to do,” she said. “It just doesn’t sound like a good public health policy.”
Authorization for Moderna’s booster could arrive in days or weeks. The company has filed its booster application with the F.D.A., calling for a shot carrying half the dosage given in the first two shots. That detail has complicated the agency’s deliberations.
The F.D.A. has not yet received any application from Johnson & Johnson for a booster of its vaccine.
Mr. Biden announced a plan for Pfizer and Moderna boosters in mid-August, but it was followed by criticism that the White House was getting ahead of the regulatory process, and internal disagreement in the Biden administration about the need for boosters.
Over the weeks, many independent scientists and regulators had emphasized that there was little research on who might benefit from the extra shots. Eventually the plan to quickly provide Moderna boosters was dropped, to give the F.D.A. more time to collect and study data.
Also complicating the issue of boosters is that some experts support a mix-and-match strategy, that is, using a dose from a different maker than the individual’s initial doses. Federal regulators have indicated that there was insufficient evidence for mixing first shots of the Moderna vaccine with a Pfizer booster, or vice versa.
Credit…James Estrin/The New York Times
In Buffalo, the Erie County Medical Center plans to suspend elective in-patient surgeries and not take intensive-care patients from other hospitals because it may soon fire about 400 employees who have chosen not to get vaccinated against the coronavirus by the state’s deadline to do so this coming Monday.
Officials at Northwell Health, New York’s largest provider of health care, estimate that they might have to fire thousands of people who have refused to get vaccinated.
And while the vast majority of staff members at New York City’s largest private hospital network, NewYork-Presbyterian, had been vaccinated as this week, more than 200 employees faced termination because they had not.
These are just a fraction of the workers at risk of losing their jobs or being put on unpaid leave after Monday, when a state directive requiring hospital and nursing home employees in the state to have received at least one shot of a Covid vaccine takes effect.
As of Sept. 22, state data shows, around 84 percent of New York’s 450,000 hospital workers and 83 percent of its 145,400 nursing home employees had been fully vaccinated. But tens of thousands of others are estimated not to have gotten a shot despite the threat of losing their jobs. Common explanations from the holdouts include fear of potential side effects, natural immunity from a coronavirus infection and the beliefs that the state mandate violates their personal freedom.
On Thursday, Gov. Kathy Hochul said that the Monday deadline was firm and that her administration was developing emergency plans to cover for those who are laid off, going so far as to look into recruiting temporary workers from the Philippines or Ireland.
“What is looming for Monday is completely avoidable, and there’s no excuses,” Ms. Hochul said, pleading for those who have not done so to get vaccinated.
Eliza Shapiro contributed reporting.
A dramatic scene played out on “The View” on Friday morning when two of the show’s hosts, Ana Navarro and Sunny Hostin, were directed to leave the set live on the air after both had apparently tested positive for the coronavirus.
“The View” had just returned from a commercial break about 15 minutes into the show and the four hosts of were on the verge of introducing Vice President Kamala Harris for an in-person interview. ABC News had been billing it as Ms. Harris’ first in-studio interview since taking office.
Then the mayhem began.
“OK, we’re back, there seems to be something happening here that I’m not 100 percent aware of,” said Joy Behar, one of the hosts, as she glanced around the set, looking perplexed. “Can someone please apprise me of the situation?”
In the background, a producer was overheard saying, “I need the two of you to step off for a second,” apparently gesturing to Ms. Navarro and Ms. Hostin. Both came off the set.
“So shall I introduce the vice president?” Ms. Behar said, looking over to a producer.
“Yes,” the producer replied, before another person off screen barked, “No!”
“As we always do in television when we’re in a tight spot, we’ll be right back,” Ms. Behar said, before the show abruptly went into a commercial break.
When “The View” returned after a five-minute break, Ms. Behar told viewers what happened.
“OK, so since this is going to be a major news story any minute now, what happened is Sunny and Ana apparently tested positive for Covid,” Ms. Behar said. “No matter how hard we try, these things happen, they probably have a breakthrough case. They’ll be OK, I’m sure, because they are both vaccinated up the wazoo.”
ABC News did not return requests for comment. Whoopi Goldberg, the show’s fifth host, was not on set on Friday.
For the next half-hour, Ms. Behar and her remaining co-host, Sara Haines, scrambled and took questions from the studio audience as they tried to, as Ms. Behar put it, “tap dance” their way through what would have been an interview with the vice president.
Ms. Harris was ushered to a remote location and joined the show for a brief interview via satellite in the final 10 minutes of the show.
MOSCOW — Russia reported its worst-ever single-day Covid-19 death toll on Friday as coronavirus cases rise in some areas and vaccine hesitancy remains widespread.
Russia’s daily death toll has remained essentially flat since July, in a narrow range from the 700s to just over 800. Many experts doubt the veracity of the daily numbers, in part because the death toll has been so relatively low and stable — and official figures of all kinds have been widely regarded with suspicion dating back to Soviet times. At least 300,000 more people died last year during the coronavirus pandemic than were reported in Russia’s most widely cited official statistics, according to a New York Times analysis of mortality data.
But a trend is clear. On Friday, the reported toll ticked up to its highest level yet, 828, after it tied the prior record, 820, on Thursday. And with last weekend’s parliamentary election over, officials appear to be warning more urgently about the continued spread of the virus.
Officials in the Moscow region said they had set up hundreds of new Covid hospital beds. In St. Petersburg, the government said that 348 people had been hospitalized with Covid in the last 24 hours — one of the highest such figures in Russia’s second-biggest city since early August, the Interfax news agency reported.
“The increase in illness is only beginning,” a Russian epidemiological official, Natalia Pshenichnaya, told Interfax, adding that the pandemic was developing across Russia “in a very dynamic way.”
Russia’s most recent high-profile outbreaks involve the inner circle of President Vladimir V. Putin, who has been in isolation himself after several members of his staff tested positive. Many Russians, however, have developed a laissez-faire attitude toward the virus, questioning the need to be vaccinated and often wearing masks around their chins, if at all.
Russia’s Sputnik V vaccine has been widely available since early this year, and eligibility for Covid vaccinations begins at age 18. But Russia’s health minister, Mikhail Murashko, said last week that only 47.5 million people have had at least one dose, a number that represents less than half of the eligible population.
Credit…Karsten Moran for The New York Times
The nation’s largest school system is preparing for disruption in some schools next week, as a vaccine mandate for virtually all adults working in New York City schools is set to take effect on Monday at midnight, which could result in staffing shortages by Tuesday morning.
The mandate — which requires workers to receive at least the first dose of a coronavirus vaccine by Monday and is the first mandate without a test-out option for any group of city workers — covers more than 150,000 people, including educators, school staff and central office employees.
Mayor Bill de Blasio announced the mandate last month, but thousands of Department of Education employees still haven’t received their first doses or haven’t submitted proof of vaccination, according to estimates from the D.O.E. and the leaders of unions representing educators.
More than 90 percent of teachers and principals have received at least one dose of a vaccine, according to union leaders, and it’s highly likely that more educators will get their first shot or submit proof of vaccination by Monday night to avoid losing their paychecks.
But Michael Mulgrew, the president of the city’s teachers’ union, said there are still roughly 6,000 teachers who will be barred from entering schools on Tuesday if they don’t get a shot over the weekend.
The teachers’ and the principals’ unions on Friday called on Mr. de Blasio to delay the implementation of the mandate until at least next weekend, so that schools have more time to plan for the shortages. Later on Friday, Mr. de Blasio resisted those calls during a radio appearance and said the city had “thousands” of substitutes ready to fill vacancies in schools next week.
Educators who refuse to be vaccinated will be able to take a year of unpaid leave and keep their health insurance until the end of the school year.
The city has said it will send vaccinated substitute teachers and central office staff into schools to cover shortages. But the most pressing challenges may not be in the classroom: Only about 80 percent of school staff, including aides, custodians, safety agents and school lunch helpers, have received at least one dose.
In many schools, almost all adults are vaccinated. But in others, there are between 30 and 100 teachers and staff members who have not yet received a vaccine dose, according to Mark Cannizzaro, who runs the city’s principals’ union.
Both the teachers’ and the principals’ unions are part of a lawsuit with other municipal unions challenging the vaccine mandate, but officials have acknowledged that the suit is likely to be unsuccessful.
Educators have been eligible for the vaccine since January.
Credit…Katie Currid for The New York Times
School mask mandates have generated controversy in many parts of the country. Now, two studies, published on Friday by the Centers for Disease Control and Prevention, provide additional evidence that masks protect children from the coronavirus, even when community rates are high and the contagious Delta variant is circulating.
One study, conducted in Arizona, where children returned to school in July, found that schools that did not require staff and students to wear masks were 3.5 times as likely to have a virus outbreak as schools that required universal masking.
A second study looked at infections among all children in 520 different counties across the United States, and found that once the public school year started, pediatric cases increased at a far higher rate in counties where schools did not require masks.
The first study analyzed data on about 1,000 public schools in Maricopa and Pima counties, which include the metropolitan areas of Phoenix and Tucson, and account for most of the state’s population.
Only 21 percent of the schools implemented a universal mask mandate upon opening, and nearly half had no mask requirement at all. Another roughly 30 percent enacted a mask requirement about 15 days after school started.
Between July 15 and Aug. 31, there were 191 school-associated virus outbreaks that occurred about a week after school started. The majority of them — 113 outbreaks, or nearly 60 percent of the total — occurred in schools with no mask requirement.
Only 16 outbreaks, or 8 percent of the total, took place in schools that implemented mask requirements regardless of vaccination status from the start. There were 62 outbreaks, or about one-third of the total amount, in schools that implemented a mask requirement after the school year had already started.
The study defined an outbreak as two or more positive confirmed cases of infection among staff or students within a 14-day period.
“The school year starts very early in Arizona, in mid-July, so we had the advantage of being able to get an early look at data for the new school year a bit sooner than was possible for the rest of the country, which was important, because of the transmission of the Delta variant,” said J. Mac McCullough, associate professor at Arizona State University and a co-author of the study.
The C.D.C. recommends a layered approach to preventing coronavirus outbreaks in schools — masking, distancing, staying home when sick and vaccination for those eligible. “This study really shines a lens on the masking part of that,” Dr. McCullough said.
The second study looked at the association between school mask policies in a given county and communitywide infections among children, finding that counties with no school mask requirement experienced a larger uptick in pediatric case rates after the start of school than counties with school mask requirements.
Between the week before school started and the second week of school, the number of pediatric infections increased by 35 cases per 100,000 in counties without mask requirements, while the number increased by 16 cases per 100,000 population in counties with school mask requirements.
Credit…Hani Mohammed/Associated Press
War-torn Yemen, where the overwhelming majority of the population is unvaccinated, is seeing coronavirus cases multiply and deaths soar, according to a report this week by the charity Oxfam.
Oxfam, which describes itself as a global anti-poverty and humanitarian group, found that Covid deaths had increased by more than fivefold in the past month and that recorded Covid cases had tripled. The charity said actual figures were likely to be much higher, with many unregistered cases and deaths.
The official Covid death toll is about 1,658, and recorded cases have reached 8,789. But the situation in the country of about 30 million is hard to gauge. “Countless” others have died in their homes or have not been diagnosed because of scarce tests and hospital beds, Oxfam said.
Yemen is still embroiled in a war that began in 2014 when Iran-backed rebels know as the Houthis seized the country’s northwest, including the capital, Sana, sending the government into exile. The government has effectively collapsed, and tens of thousands have died.
The country already faced many health challenges before the coronavirus emerged. Hunger is widespread, medicines are hard to find and there have been outbreaks of cholera and other diseases.
The pandemic has only exacerbated the situation, and rights groups say that it is adding to the burden of an already wrecked health care system.
“Covid has made life even worse for people across the country,” Abdulwasea Mohammed, Oxfam’s policy and advocacy lead for Yemen, said by phone from Sana.
Some relief could come with vaccines, but fewer than 1 percent of Yemenis have so far received a single vaccine dose, and only 0.05 percent are fully vaccinated, according to Oxfam.
The country is relying on vaccines from the global Covax program. But Covax is struggling to meet its global supply target, and only half a million out of a promised 4.2 million doses have reached Yemen so far, Oxfam said.
Few isolation centers exist for Covid patients. The ones that are operating are found only in major cities like the capital Sana, and they are overflowing with people, Mr. Mohammed said. The poorly equipped hospitals are also seeing more people than they can accommodate. And many Yemenis cannot afford transportation to health care facilities.
With half the population having lost their source of income, staying at home means possibly dying of hunger for many Yemenis who have become day earners, Mr. Mohammed said. But appearing to be sick means being shunned, so if they have mild symptoms, people are reluctant to seek medical care or testing for the virus at the very few testing centers available.
In shelters that host over 4 million internally displaced people, a family of 10 is likely to share one small tent, making precautionary measures impossible.
“The country is not able to cope with another health crisis,” Mr. Mohammed said.
Most Yemenis survive on humanitarian aid, which Oxfam says has been in short supply. Only half of a $3.9 billion essential aid package requested by the United Nations from donor countries has been received. The health care system is dangerously underfunded, working with only 11 percent of what it needs, the organization says.
Some had hoped that the pandemic would force Yemen’s warring parties into a truce, but the war continues.
“If anything, it is amazing how little the pandemic has affected the fighting,” said Peter Salisbury, a senior analyst on Yemen for the International Crisis Group, in an interview.
The terror and uncertainty of the war, which has forced people to deal with loss on a daily basis for years, remains a larger concern for many Yemenis than the pandemic itself. “This speaks to the trauma of the conflict,” Mr. Salisbury said.
Credit…Brandon Thibodeaux for The New York Times
A World Health Organization panel has endorsed the use of a monoclonal antibody treatment for Covid patients at the greatest risk of being hospitalized or those who are not producing antibodies to fight off the disease.
The treatment, developed by the U.S. drug maker Regeneron and the Swiss biotech company Roche, delivers via infusion lab-made copies of the antibodies that people generate naturally when fighting infection. It has garnered attention as an alternative — and expensive — therapy for Covid-19, particularly among some who have shunned vaccines. A cocktail of two antibodies administered by infusion, the treatment was given last fall to former President Donald J. Trump shortly after he was diagnosed with Covid.
The Biden administration has also championed the treatment’s use in states where vaccinations have stalled and cases are rising, and its use has soared in the less vaccinated Southern states.
The W.H.O. panel cited data from three unpublished clinical trials, as well as a large British study of Covid patients known as Recovery, that showed that the treatment likely reduces the risk of hospitalization in mildly ill patients who are likely to get much worse, because they are, for instance, older, unvaccinated or immunocompromised. The data also showed that the treatment lowers the likelihood of being put on a ventilator or dying among hospitalized Covid patients who do not seem to making their own antibodies.
Data from the Recovery trial indicated that the treatment probably reduced deaths by as many as 49 per 1,000 among severely ill patients and 87 per 1,000 in those who were critically ill, according to a news release issued on Thursday.
However, the panel found that for patients at lower risk and those with less serious symptoms, “any benefits of this antibody treatment are unlikely to be meaningful” and urged such patients to avoid seeking it “in order not to exacerbate health inequity and limited availability of the therapy.”
On Friday, the W.H.O. urged Regeneron and Roche to reduce the price of the treatment and make it more widely available, especially in low- and middle-income countries. The W.H.O. said that it was in talks with Roche, which is manufacturing the drug, to donate doses to the United Nations children’s agency, Unicef, for distribution in selected areas.
In the United States, some health experts have worried that promoting the therapy, which the government covers at a cost of $2,100 per dose, was taking away time and money from the effort to get more Americans vaccinated against Covid.
However, the Biden administration is operating on both tracks, promoting vaccinations as well as the therapy. Last month, while emphasizing that vaccinations were the best way to prevent Covid, Dr. Marcella Nunez-Smith, a White House adviser on racial equity in health, said the administration “continues to stand ready to assist states and territories and jurisdictions across the country to get more people connected” to antibody treatments.
Credit…Loren Holmes/Anchorage Daily News, via Associated Press
Alaska, once a leader in vaccinating its citizens, is now in the throes of its worst coronavirus surge of the pandemic, as the Delta variant rips through the state, swamping hospitals with patients.
As of Thursday, the state was averaging 125 new cases a day for every 100,000 people, more than any other in the nation, according to recent data trends collected by The New York Times. That figure has shot up by 46 percent in the last two weeks, and by more than twentyfold since early July.
About this data
Source: U.S. Department of Health and Human Services. The seven-day average is the average of a day and the previous six days of data. Currently hospitalized is the most recent number of patients with Covid-19 reported by hospitals in the state for the four days prior. Dips and spikes could be due to inconsistent reporting by hospitals. Hospitalization numbers early in the pandemic are undercounts due to incomplete reporting by hospitals to the federal government.
On Wednesday, the state said it had activated “crisis standards of care,” giving hospitals legal protections for triage decisions that force them to give some patients substandard care. The state also announced an $87 million contract to bring in hundreds of temporary health care workers.
Gov. Mike Dunleavy, a Republican, said that while hospitals were strained, he did not see a need to implement restrictions aimed at curbing transmission. Still, he encouraged people who had not yet received a vaccination to seriously consider it.
“We have the tools available to us for individuals to be able to take care of themselves,” Mr. Dunleavy said. While the state led the nation in vaccinations early in the year, it has been lagging in recent months, with half of its population fully vaccinated, compared with 55 percent nationally, according to federal data.
Jared Kosin, the head of the Alaska State Hospital and Nursing Home Association, called the surge “crippling” in an interview on Tuesday. He added that hospitals were full, and health care workers were emotionally depleted. Patients recently were kept waiting for care in their cars outside overwhelmed emergency rooms.
There is growing anxiety in outlying communities that depend on transferring seriously ill patients to hospitals in Anchorage, Mr. Kosin said. Transfers are getting harder to arrange and are often delayed, he said.
“We are all wondering where this goes, and whether that transfer will be available, even tomorrow,” Mr. Kosin said.
Critically ill people in rural areas, where many Alaska Natives reside, often have to be taken by plane to a hospital that can provide the treatment they need, said Dr. Philippe Amstislavski, an associate professor of public health at the University of Alaska Anchorage.
“Unlike in the lower 48, you don’t have that ability to move people quickly, because of the distances and remoteness,” said Dr. Amstislavski, who was formerly the public health manager for the Interior Region of Alaska, focusing on rural and predominantly Alaska Native communities.
Mr. Kosin said that if hospitalizations rise much further, hospitals and clinics around the state could be forced to apply crisis standards of care and more extreme triage decisions. “That is the worst-case scenario we could be heading to,” he said.
Alaska Natives, who have historically suffered from health disparities in the state, are disproportionately struggling during the latest virus wave, Dr. Amstislavski said.
Dr. Anne Zink, Alaska’s chief medical officer, said several factors may be contributing to the surge, including summer tourists bringing in and spreading the virus.
“We’re hoping that as the snow falls and we have less people visiting, those numbers will settle down,” Dr. Zink said in an interview Tuesday night.
On the other hand, she noted that cooling weather drives residents indoors, where the virus spreads more readily.
The state’s Canadian neighbors to the east, Yukon and British Columbia, have not suffered such severe outbreaks, Dr. Amstislavski said, possibly because of that country’s stricter travel restrictions and less strained health care system.
Credit…Ahn Young-Joon/Associated Press
SEOUL — South Korea reported its highest number of new coronavirus infections for a single day on Friday, soon after a long holiday weekend.
The Korea Disease Control and Prevention Agency reported 2,434 new infections, surpassing the previous record of 2,221 infections set last month.
At a briefing on Friday, health officials said the spike was partly because of the Chuseok holiday, when many people traveled across the country and spent time with friends and family. The government is encouraging people to get tested following the holiday.
Chuseok is roughly equivalent to American Thanksgiving and was observed from Monday through Wednesday. The Korea Transport Institute estimated that over 32 million people would travel over the holiday.
Over the past week the nation was averaging about 1,500 new cases a day, according to statistics collected by Our World in Data. Most cases are concentrated in the capital, Seoul, and surrounding areas, but officials were concerned that the holiday would spread the virus more widely.
Testing and quarantining were the main tools South Korea used to curb the spread of the disease, and the country was able to keep outbreaks at bay in the early part of the pandemic.
South Korea’s vaccination program got off to a slow start, but the country has now vaccinated 43 percent of its population. It hopes to have 70 percent of its population inoculated by October.
“There is no problem at all with the amount of vaccines secured for this year,” President Moon Jae-in said on Friday, according to Reuters. “The vaccine shipment got off to a slower start than other countries, which delayed the vaccination program, but I believe by next month, we will catch up and be a leading country by inoculation rate.”
A few weeks ago the government relaxed several restrictions on in-person meetings. For Chuseok, family gatherings of up to eight people were permitted if at least four people were fully vaccinated.
Credit…Adem Altan/Agence France-Presse — Getty Images
A one-month-old baby in Turkey was mistakenly injected with Pfizer-BioNTech’s Covid vaccine in July, officials, doctors and the family said this week.
The baby is in good health and has shown no adverse effects, but doctors are still monitoring it closely, health officials said.
The baby’s family brought it to their doctor’s clinic in the western province of Izmir in July for a hepatitis B shot, one of the childhood vaccinations given to all babies when they turn a month old in Turkey.
But instead the baby was given a coronavirus injection, an error that surprised health professionals around the country because the vaccination system is computer-monitored. As a security measure, every shot is matched to the name of the recipient using a bar code.
A couple of hours after the appointment, officials went to the family’s residence and alerted them to the error. They were told to take their baby to the hospital, Dilek Guzel, a lawyer representing the family, said in a statement.
The baby was monitored in the hospital for a week, Ms. Guzel said. The family has not been named publicly.
“My clients are told that it is unknown whether any permanent problem because of the vaccine would occur or not,” Ms. Guzel said, adding that the baby is still being monitored.
The incident came to light earlier this week during a television interview with Zafer Kurugol, a professor of child diseases at Ege University Hospital in Izmir, who examined the infant after the injection.
“We monitored this baby for days, just in case anything might happen,” Dr. Kurugol told NTV radio. There were no ill effects, he said, and the baby, who was given an adult dose, developed antibodies against the coronavirus.
Dr. Kurugol was being interviewed about the safety of vaccines. But his anecdote about the baby drew the ire of his colleagues, health officials and the public. Many of his colleagues considered his remarks to be disrespectful to family physicians around the country who handle the vaccination of babies as well as coronavirus vaccinations. Anti-vaccine critics also took the incident as more proof for their concerns.
Turkey has administered more than 107 million coronavirus vaccinations and has fully vaccinated 64 percent of its population, according to the Our World in Data project at the University of Oxford.
After Dr. Kurugol’s remarks, the Health Ministry said that an investigation had already been opened, as the nurse who administered the shot reported himself, and the computer-based system also flagged the error. The ministry said it would also investigate Dr. Kurugol because of his “unfortunate” remarks.
Dr. Kurugol said the case of the infant would soon be published in a respected scientific journal, with the written consent of the family.
The family also made a criminal complaint, saying they wanted to prevent any similar mistakes from happening.
“The family believes in science,” Ms. Guzel said. “They don’t want their baby’s case to be turned into an anti-vaccination campaign.”